Ultrasonic Decalcification for Mitral Stenosis with Mitral Annular Calcification : a Case Report / 日本心臓血管外科学会雑誌

Mitral valve surgeries for cases with mitral annular calcification (MAC) are challenging because of the operative complications. For a case of MS with MAC, we achieved mitral valve plasty by ultrasonic decalcification alone. An 82-year-old male with edema and dyspnea was diagnosed with AS and MS with MAC. MAC was so severe that MVR was challenging. There were calcifications at the anterior commissure and the anterior mitral leaflet (AML), and removal of them was expected to improve the valve function. Therefore, anterior commissurotomy and ultrasonic decalcification of the anterior commissural annulus was performed using cavitron ultrasonic surgical aspiration (CUSA). Following the resection of the aortic valve, we carried out decalcification of the AML through the aortic valve orifice. After AVR, a trans-esophageal echocardiogram showed MS was ameliorated. Two years after surgery, recurrence of MS was not recognized. Some mitral cases with MAC can be treated by only decalcification to avoid risky valve replacement.

Effect of ultrasonic tip designs on intraradicular post removal

OBJECTIVES: To evaluate the effect of different ultrasonic tip designs on intraradicular post removal. MATERIALS AND METHODS: The crowns of forty human canine teeth were removed, and after biomechanical preparation and filling, the roots were embedded in acrylic resin blocks. The post spaces were made, and root canal molding was performed with self-cured acrylic resin. After casting (Cu-Al), the posts were cemented with zinc phosphate cement. The specimens were randomly separated into 4 groups (n = 10), as follows: G1 - no ultrasonic vibration (control); G2 - ultrasonic vibration using an elongated cylindrical-shaped and active rounded tip; G3 - ultrasonic vibration with a flattened convex and linear active tip; G4 - ultrasonic vibration with active semicircular tapered tip. Ultrasonic vibration was applied for 15 seconds on each post surface and tensile test was performed in a Universal Testing Machine (Instron 4444 - 1 mm/min). RESULTS: G4 presented the highest mean values, however, with no statistically significant difference in comparison to G3 (P > 0.05). G2 presented the lowest mean values with statistically significant difference to G3 and G4 (P < 0.05). CONCLUSIONS: Ultrasonic vibration with elongated cylindrical-shaped and active rounded tip was most effective in reducing force required for intraradicular post removal.

Sealing Ability of MTA Used as a Root End Filling Material: Effect of the Sonic and Ultrasonic Condensation

Despite the excellent properties of mineral trioxide aggregate (MTA), the condensation technique may have some influence in its sealing ability. The purpose of this study was to compare the sealing ability of sonic and ultrasonic setting of MTA. Thirty-four extracted human teeth had their canals prepared and filled with Sealapex sealer and gutta-percha using the active lateral condensation technique. The teeth were rendered waterproof and apicoectomy performed at 3 mm from the apex. Root-end cavities (3.0 mm deep and 1.4 mm diameter) were prepared with diamond ultrasonic tips. The root-end cavities were filled with Pro-Root MTA® with ultrasonic vibration, sonic vibration or no vibration. The positive control group did not receive any material while the negative control group was totally rendered waterproof. After material set, the specimens were immersed in Rodhamine B for 24 h, under vacuum in the first 15 min, then washed, dried and split longitudinally for evaluating the infiltration at the dentin/material interface. Data were analyzed using ANOVA and Tukey's tests at 5% significance level. Sonic vibration promoted the lowest infiltration values (p<0.05). It was concluded that sonic vibration could be considered an efficient aid to improve the sealing ability of MTA when used as root-end filling material.

Resumo O objetivo deste estudo foi avaliar in vitro, a influência da vibração sônica e ultrassônica no selamento marginal proporcionado pelo MTA. Trinta e quatro dentes humanos tiveram seus canais radiculares instrumentados e obturados com cimento Sealapex® pela técnica da condensação lateral ativa. Os dentes foram impermeabilizados e seccionados os 3 mm apicais. Retrocavidades (3 mm de profundidade e 1,4 mm de diâmetro) foram preparadas com pontas ultrassônicas diamantadas. As retrocavidades foram preenchidas com Pro-Root MTA® com auxílio da vibração ultrassônica, com auxílio da vibração sônica e sem vibração alguma. O grupo controle positivo não recebeu material retrobturador, enquanto que o negativo foi totalmente impermeabilizado. Após a presa do material, os espécimes foram mergulhados em Rodamina B por 15 min em vácuo, permanecendo nesta solução por mais 24 h. Em seguida, foram lavados, secados e clivados longitudinalmente para avaliação da infiltração do corante na interface dentina/material retrobturador. Os dados foram analisados utilizando a análise de variância e o teste de Tukey (p<0,05). Observou-se que apenas a vibração sônica foi diferente apresentando os menores índices de infiltração. Pode-se concluir que vibração sônica contribui com a melhora da capacidade de selamento marginal proporcionado pelo MTA quando empregado como material retrobturador. .

A Comparative study on the palatal mucosa thickness measurements using periodontal probe and pltrasonic device / 대한치주과학회지

Maxillary palatal mucosa is the most frequently used donor site of the soft tissue for periodontal plastic surgery. In our study, thickness of the palatal mucosa between the mesial side of the maxillary first premolars and the distal side of the maxillary first molars was measured with a periodontal probe and an ultrasonic device in 30 young Korean adults. Using the data, the possibility of the clinical application of ultrasonic devices was evaluated. The results of this study were as follow; 1. The thickness of the palatal mucosa of the maxillary premolars is the thickest and that of the mid-palatal portion of the maxillary first molar is the thinnest. 2. The thickness of the palatal mucosal tissue increases from the gingival margin to the mid-palatal suture. 3. The measurements of the periodontal probe and the ultrasonic device revealed the strong positive correlations.

Analysis of benefit and cost on color ultrasonic devices / 医疗卫生装备

Objective To find out the benefit and cost of color ultrasonic devices in our hospital after the drop of large equipment examine fee.Methods Data of benefit and cost on 7 color ultrasonic devices in using are collected and analyzed by using Benefit Cost Ratio(BCR) method.Results The higher valuable the equipments are,the more fixed cost they have with lower BCR.Conclusion Buying cheaper equipment is the only way to increase the pure benefit under the precondition of normal diagnosis by devices.

Root surface roughness following mechanical instrumentation in vivo and in vitro SEM study / 대한치주과학회지

Adequate root preparation in the treatment of periodontal disease often involves mechanical instrumentation to remove plaque, calculus perhaps contaminated cementum. Although meticulous scaling and root planing may remove some cementum, the use of aggressive root planing to remove cementum does not appear warranted. So ultrasonic device and rotary instrument appear to be replacing hand instrument. But it is not clear those instruments make smooth root surface as hand instrument. The roghness of the root surface were evaluate with SEM following instrumentation with Gracey curette, Perio Clean and piezo ultrasonic device(Setlec) with various tip. 20 extracted teeth were used in vitro experiment, and 9 teeth of a patient destined for extraction for periodontal reasons were utilized in vivo experiment. It was demonstrated that hand curette created the smoothest surface, while diamond tip tended to roughen the root surface. But the hand curette, Perio Clean, and piezo ultasonic device with scaler tip tend to remove cementum completely. Piezo ultrasonic device with curette-like tip made the desirable smooth surface with partial removal of cementum.

Root surface roughness following mechanical instrumentation, in vitro 3 dimensional planimetric study / 대한치주과학회지

A primary goal of periodontal therapy is the creation of root surfaces that are free of plaque and calculus. It is not yet to be determined whether it is desirable to have a smooth root surface after treatment. It is also not clear what degree of roughness result from different instruments. In the present study various instruments for root surface debridement were evaluated. 20 extracted teeth were utilized, and the teeth were treated with one of the following instrument: Gracey curette, Perio Clean, and piezo ultrasonic device(Setlec, P Max) with general scaler tip, curette-like tip, and diamond tip. 3 dimensional planimetric device(Accura) was used to evaluate the average surface roughness. It was demonstrated hand and power-driven instruments did not have a significant difference in roughness of the root surface following instrumentation. And ultrasonic scaler tip tended to make a most smooth surface than other instruments. The possible reasons of the result were discussed.